Provider Demographics
NPI:1922667005
Name:ROONEY, CHRISTINE E (MSN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:E
Last Name:ROONEY
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:E
Other - Last Name:BERTONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN,RN
Mailing Address - Street 1:35 BAYVIEW ST
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02191-1207
Mailing Address - Country:US
Mailing Address - Phone:617-794-2149
Mailing Address - Fax:
Practice Address - Street 1:1223 BEACON ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5302
Practice Address - Country:US
Practice Address - Phone:339-502-4717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN267276364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA